Progressive Muscle Relaxation and Applied Relaxation
[Note that this treatment is only for people who have an initial physical misophonic reflex that is a skeletal muscle, such as a clenching your fist or jerking your shoulder. If your physical reflex is internal, such as a stomach constriction or some movement in your chest cavity, then you cannot willfully relax those muscles and thereby reduce your misophonia reflex response.]
Relaxing your muscles immediately after a trigger (which is Applied Relaxation) can greatly reduce the anger response. Daily Progressive Muscle Relaxation (PMR) can also improve your general level of wellness and well-being, which leads to reducing your misophonia. Relaxing your muscles before you are triggered can change the connections in your lizard brain and slowly reduce the intensity of the misophonic physical reflex, thereby reducing the severity of your misophonia. Because of this, I include muscle relaxation both under misophonia management techniques and misophonia treatments.
The chapter on management techniques explains how to perform PMR. To use it as a treatment method, you need to become proficient in relaxing your muscles immediately, without first tensing them. Daily PMR builds the neuron connections needed to willfully relax skeletal muscles. You will likely need to do the PMR exercise every day for two weeks to begin to develop this control, but you may need to work for months to develop sufficient control to relax your muscles before and during triggers. You then need to practice Applied Relaxation and develop the skill of relaxing all your muscles quickly.
Triggers often come in groups, rather than a single trigger. A person sitting near you may be sniffling, crunching, or typing. These triggers, especially eating and typing, are almost constant. To change the connections in your brain that cause your misophonic reflex, you need to relax the muscle of your initial physical misophonic reflex before you are triggered. You can relax other muscles also, but the lizard brain learning (repatterning) comes from relaxing the muscle that is jerked by your lizard brain before you hear a trigger.
By relaxing the muscle that is jerked with the misophonic reflex, it will contract less, and almost immediately start to relax. During the critical “training” time, which is the first two seconds after the trigger, your lizard brain will detect a more relaxed muscle. Because of this, it will jerk the muscle slightly less the next time. Over time, the physical reflex can decay away. In order for this to happen, you need to be highly skilled in relaxing your muscle, and it takes practice to develop this skill. Because of this, you need lots of practice in PMR to develop the neuron connections needed to become a master muscle relaxer. You also need lots of practice of Applied Relaxation, which is relaxing your muscle on command, without tensing it. The most important muscle to learn to relax is the muscle of your initial physical misophonic reflex.
Relaxing your muscles before and during a trigger may seem like a little thing, but it’s not: it’s a powerful lizard brain training/changing activity. Remember that it’s a difficult skill to master, so keep up your daily PMR exercises. Rather than thinking of it as PMR (Progressive Muscle Relaxation), think of it as MRP – Muscle Relaxation Practice. You can do this (relax your reflex muscle) and repattern your lizard brain. The Neural Repatterning Technique (NRT) discussed in the next section can help you learn this skill because it uses a reduced intensity trigger, making it easier to relax.
Eight months after learning about muscle relaxation from the individual at the first misophonia conference, the same man reported his good news at the 2013 Misophonia Association Conference. After years of relaxing after being triggered to control his anger, he discovered that he could relax before triggers. As a member of the patient panel, he reported to the conference that he had virtually eliminated his misophonia by relaxing his muscles during trigger situations.[i] This is Applied Relaxation at its best!
This likely worked at two levels. First, relaxing muscles continually will likely allow you to maintain your muscles in a relaxed state and therefore reduce the anger response. A second way this likely works is to slowly reduce the physical reflex. This man’s initial physical reflex was pulling his shoulders toward his ears, so by relaxing those muscles before a trigger, he reduced the severity of the physical response to that trigger. This created a lizard brain repatterning event so that the reflex was reduced ever so slightly for the next trigger. My journal article, “Treating the Initial Physical Reflex of Misophonia with the Neural Repatterning Technique: A Counterconditioning Procedure,”[ii] provides an extensive report of another individual who learned to relax her physical reflex. This article is available to you on MisophoniaTreatment.com. This person started with PMR and then practiced relaxing to very small triggers during Neural Repatterning Technique (NRT) treatments using the Trigger Tamer app. After eliminating two triggers with the NRT treatment, she relaxed her muscles in real life situations, and continued to reduce her misophonic triggers.
It might sound trivial to learn to relax your muscles with PMR, but done properly, it can allow you to develop the skill you need to greatly reduce or overcome your misophonia.
[i] Martz, 2013
[ii] Dozier, in press